Changes in picturing of ‘self’ in social anxiety disorder: a case report

2015 ◽  
Vol 8 ◽  
Author(s):  
Yasuko Tanaka ◽  
Osamu Kobori ◽  
Michko Nakazato
Keyword(s):  
Case Report ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Social Performance ◽  
Behavioural Therapy ◽  
Assessment Method ◽  
Case Formulation ◽  
Projective Drawing ◽  
Scale Scores

AbstractSocial anxiety disorder (SAD) is characterized by significant distress regarding social performance situations. Patients experience strong embarrassment about how they are perceived by others due to increased self-focused attention. This case report presents two cases of SAD and the effects of cognitive behavioural therapy (CBT) on ‘picturing of self’ (e.g. self-picturing and self-projection). The goal was to demonstrate the changes in ‘picturing of self’ using brief video feedback (VF) as a treatment and projective drawing as an assessment method of CBT, especially with SAD. The CBT consisted of psychoeducation and case formulation, cognitive restructuring, and behavioural experiments. In one case VF was used to provide additional means by showing the patient's own actual moving figure, the self-picture. For the other case, the patient was instructed to ‘draw a person’ and the changes in drawing style were assessed. Through the course of CBT, Liebowitz Social Anxiety Scale scores reduced significantly in both cases. ‘Picturing of self’ changed as a result of the use of CBT. Brief VF and projective drawing would be useful for individuals to see the change in themselves.

scholarly journals Performance anxiety disorder: Developing a proposal for an inventory, according to the cognitive-behavioural therapy rationale

2017 ◽  
Vol 10 (2) ◽  
pp. 236-246 ◽  
Author(s):  
George Varvatsoulias
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Performance Anxiety ◽  
Behavioural Therapy ◽  
External Shame ◽  
Cognitive Behavioural ◽  
The Future

This editorial aims at the presentation of a proposal regarding an inventory about performance anxiety disorder in a cognitive-behavioural therapy (CBT) framework. It provides some initial understanding as to that condition and how CBT could assist in the consideration of it counter to social anxiety disorder. At first, there is an introduction to performance anxiety in line to social anxiety/phobia and some questionnaires that have been developed which include performance anxiety as an element of social anxiety/phobia. Then, I am presenting the proposal, both in view to the rationale for that and the construction of an inventory with items drawn from elements that performance anxiety is related with, such as uneasiness about worry, self-focus issues of perfectionism and internal/external shame ideas. The statements in the inventory refer to hypothetical examples in life so inventory to be easily responded to, when administered to participants. This proposal closes with the conclusion that the questionnaire will be pilot-studied in the future by the author so the feasibility of it and/or possible changes to be considered when empirically studied.

Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study

2020 ◽  
Vol 48 (6) ◽  
pp. 745-750
Author(s):  
Justin W. Weeks ◽  
M. Taylor Wilmer ◽  
Carrie M. Potter ◽  
Elizabeth M. Waldron ◽  
Mark Versella ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Proof Of Principle ◽  
Fear Of Positive Evaluation ◽  
Positive Evaluation

AbstractBackground:Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.Aims:To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.Method:Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.Results:A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.Conclusions:Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

scholarly journals Therapist-guided internet-delivered cognitive–behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018345 ◽  
Author(s):  
Martina Nordh ◽  
Sarah Vigerland ◽  
Lars-Göran Öst ◽  
Brjánn Ljótsson ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Feasibility Trial ◽  
Cognitive Behavioural ◽  
Exposure Sessions

ObjectivesSocial anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%–4% and increased risk of adverse long-term outcomes, such as depression. Cognitive–behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT).DesignA proof-of-concept, open clinical trial with 6-month follow-up.ParticipantsThe trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13–17 years old (83% girls) with a principal diagnosis of SAD.Intervention12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents.ResultsAdolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD.ConclusionTherapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD.Trial registration numberNCT02576171; Results.

It hurts but I still need it: a qualitative investigation of post-event processing in social anxiety disorder

2019 ◽  
Vol 48 (3) ◽  
pp. 364-369
Author(s):  
Naoki Yoshinaga ◽  
Kota Takaoka ◽  
Osamu Kobori
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Social Performance ◽  
Event Processing ◽  
Structured Interviews ◽  
Intermittent Reinforcement ◽  
Metacognitive Beliefs ◽  
Research Questions ◽  
Do So

AbstractBackground:It has been proposed that both positive and negative metacognitive beliefs sustain engagement in post-event processing (PEP). However, it is unknown: (1) whether individuals with social anxiety disorder (SAD) actually derive the benefits from PEP that they expect; (2) if this is not the case, how their positive beliefs are maintained; and (3) if they are aware of the counterproductive effects of PEP, why they still perform PEP.Aims:To explore the phenomenology of the processes involved in PEP from the perspective of SADs, in order to address the research questions above.Method:Twenty-one participants suffering from SAD received individual semi-structured interviews. Transcripts were analysed using thematic analysis.Results:Analysis revealed three main themes: (1) ‘Only, safe and useful way to improve myself’: SADs feel the need to improve their social performance, and they believe that PEP is the only, safe, and private way to do so, which is an underlying motive for them to do PEP; (2) ‘It hurts more than helps me’: however, through PEP, they do not seem to obtain the benefit that they expect, or only find a variety of counterproductive outcomes; (3) ‘Better safe than sorry’: they sometimes find makeshift solutions to improve their social performance during PEP, which may maintain their PEP as a form of intermittent reinforcement. They weigh up such costs and benefits, and choose to perform PEP while feeling conflicted about PEP.Conclusions:The results suggest that: (1) SADs rarely obtain the benefits from PEP that they expect; (2) their positive metacognitive beliefs are maintained by solutions they sometimes find during PEP; and (3) SADs choose to perform PEP while feeling conflicted; while PEP ironically maintains and exacerbates negative self-beliefs/images, it is the only safe and useful way to improve their social performance. These findings support and expand on the theories of PEP.

What determines observer-rated social performance in individuals with social anxiety disorder?

2010 ◽  
Vol 24 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Stephan Stevens ◽  
Mareike Hofmann ◽  
Sonja Kiko ◽  
Anna Katharina Mall ◽  
Regina Steil ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Social Performance

scholarly journals The Role of Environmental Factors in the Aetiology of Social Anxiety Disorder: A Review of the Theoretical and Empirical Literature

2017 ◽  
Vol 34 (2) ◽  
pp. 76-97 ◽  
Author(s):  
Alice R. Norton ◽  
Maree J. Abbott
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Environmental Factors ◽  
Attachment Style ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Social Performance ◽  
Empirical Literature ◽  
Peer Experiences ◽  
Current Article

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social/performance situations, and a number of key environmental factors have been implicated in the aetiology of the disorder. Hence, the current article reviews theoretical and empirical evidence linking the development of SAD with parenting factors, traumatic life events, and aversive social experiences. Specifically, research suggests that the risk of developing SAD is increased by over-controlling, critical and cold parenting, an insecure attachment style, aversive social/peer experiences, emotional maltreatment, and to a lesser extent other forms of childhood maltreatment and adversity. Moreover, these factors may lead to posttraumatic reactions, distorted negative self-imagery, and internalised shame-based schemas that subsequently maintain SAD symptomatology. However, further research is necessary to clarify the nature, interactions, and relative contributions of these factors. It is likely that SAD develops via a complex interplay of biological and environmental factors, and that multiple aetiological pathways underlie the development of the disorder.

scholarly journals Inflated sense of responsibility, explanatory style and the cognitive model of social anxiety disorder: a brief report of a case control study

2019 ◽  
Vol 12 ◽  
Author(s):  
Matthew Jones ◽  
Sarah Rakovshik
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Explanatory Style ◽  
Causal Attribution ◽  
Cognitive Model ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Inflated Responsibility

AbstractWe sought to investigate situation-specific inflated sense of responsibility and explanatory style in social anxiety disorder (SAD) according to the cognitive model. Participants aged 17–68 years (mean = 31.9, SD = 11.1) included waiting list patients referred to a primary care mental health service for cognitive behavioural therapy for SAD (n = 18) and non-anxious control participants (n = 65). A battery of psychometric measures, including a bespoke measure of responsibility beliefs, was used. Compared with controls, participants with SAD were more likely to demonstrate an inflated sense of responsibility (p ≤ 0.001), and to adopt a negative explanatory style specific to social interaction (p ≤ 0.01). Inflated sense of responsibility was found to correlate with SAD symptomatology (r = 0.47, p ≤ 0.05), and with increased usage of safety behaviours (r = 0.47, p ≤ 0.05). Caseness (β = 1.45, p ≤ 0.01) and stability of causal attribution (β = 0.25, p ≤ 0.001) were found to predict inflated responsibility in our sample. To our knowledge this study represents the first attempt to investigate inflated responsibility within the context of SAD. Our results support the notion of inflated responsibility as a feature of SAD.Key learning aims(1)To understand the cognitive behavioural components of Clark and Wells’ model of SAD, and their bi-directional nature.(2)To understand what the term ‘inflated sense of responsibility’ refers to, and how it relates to CBT.(3)To understand what the term ‘explanatory style’ refers to, and how this concept can also relate to CBT.

The Effectiveness of Drama Therapy on Decreasing of the Symptoms of Social Anxiety Disorder in Children

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
A. Anari ◽  
P. Ddadsetan ◽  
B. Saleh Sedghpour
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Children And Adolescents ◽  
Social Anxiety Disorder ◽  
Social Performance ◽  
Drama Therapy ◽  
Anxiety Scale ◽  
Control Group ◽  
Liebowitz Social Anxiety Scale ◽  
Experimental Group

The effectiveness of Drama therapy on decreasing of the symptoms of Social Anxiety Disorder (Performance Anxiety, Performance Avoidance, Social Anxiety & Social Performance Subtests) in 10-11 years old children was investigated in this study. 2 schools were randomly selected from elementary schools of Tehran city. First, Validation the Liebowitz Social Anxiety Scale for Children and Adolescents (Liebowitz, Klein & Masia-Warner, 2003) is done in one of that school; Then, in two schools, from 300 children ages 10-11, 32 children whose had received the highest scores on the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) were selected. Subjects were divided into control and experimental groups. Experimental group received Drama therapy intervention for 6 weeks, twice a week sessions lasting two hours. The results were analyzed using covariance and indicated the children in experimental group reported a significant decrease in symptoms of Social Anxiety Disorder (Performance Anxiety, Performance Avoidance, Social Anxiety & Social Performance Subtests) as compared to the control group. In addition, in 3 month follow up, results had stabilized in experimental group as compared to the control group. The emerged findings can have clinical application in prevention and treatment of social anxiety disorder in children.

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